Behavioral therapy notes are important for both legal compliance and patient care. Unlike progress notes in physical health, quality standards for behavioral therapy notes remain underdeveloped. To address this gap, we collaborated with licensed therapists to design a comprehensive rubric for evaluating therapy notes across key dimensions: completeness, conciseness, and faithfulness. Further, we extend a public dataset of behavioral health conversations with therapist-written notes and LLM-generated notes, and apply our evaluation framework to measure their quality. We find that: (1) A rubric-based manual evaluation protocol offers more reliable and interpretable results than traditional Likert-scale annotations. (2) LLMs can mimic human evaluators in assessing completeness and conciseness but struggle with faithfulness. (3) Therapist-written notes often lack completeness and conciseness, while LLM-generated notes contain hallucinations. Surprisingly, in a blind test, therapists prefer and judge LLM-generated notes to be superior to therapist-written notes. As recruiting therapists for annotation is expensive, we will release the rubric, therapist-written notes, and expert annotations to support future research.

Single document news summarization has seen substantial progress on faithfulness in recent years, driven by research on the evaluation of factual consistency, or hallucinations. We ask whether these advances carry over to other text summarization domains. We propose a new evaluation benchmark on topic-focused dialogue summarization, generated by LLMs of varying sizes. We provide binary sentence- level human annotations of the factual consistency of these summaries along with detailed explanations of factually inconsistent sentences. Our analysis shows that existing LLMs hallucinate significant amounts of factual errors in the dialogue domain, regardless of the model’s size. On the other hand, when LLMs, including GPT-4, serve as binary factual evaluators, they perform poorly and can be outperformed by prevailing state-of-the-art specialized factuality evaluation metrics. Finally, we conducted an analysis of hallucination types with a curated error taxonomy. We find that there are diverse errors and error distributions in model-generated summaries and that non-LLM based metrics can capture all error types better than LLM-based evaluators.